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ChiroBoards3:Heart
ChiroBoards3: Heart
| Question | Answer |
|---|---|
| Measures the pressure of the right side of the heart and can be more pronounced with CHF | Jugular venous pulsations |
| Jugular venous pulsations become more pronounced with CHF when performing this liver reflex test = | hepatojugular reflex |
| What part of HIPPIRONEL are jugular venous pulsations discovered on? | Inspection |
| Peripheral Pulses: Pulsus magnus | "bounding"; increased cardiac output; exercise, anxiety, fever, hyperthyroidism |
| Peripheral Pulses: Pulsus Parvus | weak or thready; decreased stroke volume; hypovolemia, aortic stenosis, CHF |
| Peripheral Pulses: Pulsus Alterans | alternates in amplitude: **left ventricular failure** |
| Peripheral Pulses: Pulsus Bisferiens | two strong systolic peaks separated by mid systolic dip; aortic regurgitatio and aortic stenosis |
| Where is Pulsus Bisferiens best felt at? | at the carotid artery |
| Peripheral Pulses: Pulsus Paradoxus (seen in 4 conditions) | decreased amplitude on inspiration, increased with expiration (>10mmHg amplitude change); COPD, bronchial asthma, emphysema, pericardial effusion. |
| Peripheral Pulses: Water Hammer Pulse | A jerky pulse that is rapidly increasing and then collapses because of aortic insufficiency. |
| Vibration produced by turbulent blood flow within the heart (murmurs) = | Thrills |
| Systole occurs when ... | ventricles contract |
| Diastole occurs when the ventricles are..... | at rest and filling |
| S1 = | closure of AV (mitral and tricuspid) valves |
| S2 = | closure of semilunar (pulmonary and aortic) valves |
| S3, aka... | Ventricular gallop |
| S3 = normal in; and abnormally seen with = | normal in children, young adults, and athletes >40 y.o = earliest sign of CHF |
| S4, aka... | Atrial gallop |
| S4 = | similar to S3 and is related to stiffness of the ventricular myocardium to rapid filling |
| S4 is always.... | pathological |
| The aortic valve auscultation point (2nd IC space of right sternal border) is best auscultated with patient in what position? | Seated, leaning forward, and exhaling |
| Where is the mitral valve auscultation point? | mid-clavicular line at the 5th intercostal space |
| Best patient position for performing the mitral valve auscultation point? | Left lateral decubitus positon |
| Valve has trouble opening and the blood swirls through a narrow opening = | murmur |
| Murmurs are best heard with bell or diaphram? | bell |
| Murmur = high or low pitch? | low pitch |
| Valve is insufficient and blood seeps or squirts back into the chamber | regurgitation |
| regurgitation has high or low pitch? | high pitch |
| Regurgitation = bell or diaphragm? | diaphragm |
| The mnemonic ARMS and PRTS occurs in which phase? | Diastole (opposite occurs in systole) |
| ARMS and PRTS are written horizontally or vertically when matching the mnemonic? | vertically; two columns, one for ARMS, and one for PRTS |
| What is the mnemonic for remembering heart murmur patterns? | ARMS and PRTS |
| Failure to shunt to close between the aorta and left pulmonary artery, creating continuous/machinery like murmurs = | Patent Ductus Arteriosus |
| Explain the 4 things seen with Tetralogy of Fallot = | Dextraposition of the aorta, Right ventricular hypertrophy, Interventricular septal defect, and Pulmonic stenosis (DRIP) |
| What serious congenital defect creates a loud ejection murmur during systole and severe cyanosis? | Tetralogy of Fallot |
| Constriction of the descending aorta (usually distal to the left subclavian) | Coarctation of the Aorta |
| Causes higher blood pressure in the upper extremity by 20 mmHg when compared to the lower extremity. | Coarctation of the Aorta |
| Coarctation of the Aorta is commonly associated with this condition = | Marfans Syndrome |
| Narrowed proximal to the vertebral artery. Seen in younger women who faint while exercising | Subclavian Steal Syndrome (subclavian steals from the vertebral) |
| Most common cause of left sided heart failure is | Systemic Hypertension |
| 2nd most common cause of left sided falure is | aortic stenosis |
| Early signs of Left sided Heart Failure (3) | Pulmonary Edema (fluid in lungs); Shortness of breath (exertional dyspnea) and Orthopnea |
| First sign of heart failure | exertional dyspnea |
| Left sided heart failure: fluid collects here first | costophrenic angles |
| Most common cause of mitral stenosis is = | Rheumatic fever |
| Most common cause of right sided heart failure is = | Left sided heart failure |
| When the right side fails by itself (lung condition that causes right sided heart failure) | Cor Pulmonale |
| Which gallop is seen in right sided heart failure? | S3 |
| Blood pressure increases or decreases in right sided heart failure? | decreases |
| Stasis dermatitis (late or early sign of CHF?) | late |
| Tearing pain in chest; acute medical emergency = | Aortic Dissection |
| Associated with hypertension/arteriosclerosis (descending aorta) and Marfan's (Ascending aorta) = | Aortic Dissection |
| People with Marfan's have ventricular weakness and enlargement, spider-like fingers, tall stature, and subluxation of what structure? | the lense |
| DDx between Angina Pectoris and Printzmetal Angina? | Printzmetal typically comes on with rest; Angina Pectoris comes on with exertion |
| aka for angina pectoris = | coronary vasospasm |
| what vasodilator helps treat angina pectoris? | Nitroglycerine |
| 3 lab values for diagnosing MI = | Increased CK-MB; increased SGOT, and increased LDH |
| cause of MI = | Atherosclerosis |
| Abnormal widening that involves all 3 layers; defect in elastic-media tissues | Aneurysm |
| ECG = Increased PR interval (causing prolonged AV nodal delay) = condition? | Primary Heart Block |
| ECG = Two P waves before QRS = condition? | Secondary heart block |
| Secondary heart block, aka = | Weinkbochs- block of bundle of HIS |
| ECG = No QRS = seen with = | Complete heart block |
| No ______________ contraction with complete heart block | ventricular |
| Where is atrial repolarization hidden on an ECG? | under the QRS complex |
| ECG = Inverted or enlarged ST segment = | Acute heart failure (MI) |
| Echocardigrams are used to detect what? | murmurs |
Created by:
bglasman
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